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!Small Animal Medicine > Diabetes of the dog > Flashcards

Diabetes of the dog Flashcards

1
Q

What cells are produced at the islet of Langerhans?

A

A: glucagon
B: insulin
D:somatostatin
F: Pancreatic polypeptides

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2
Q

Hypoglycemic counter-regulatory hormones

A

Epinephrine
Cortisol
Glucagon
Growth Hormone

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3
Q

Type 2 diabetes

A

Insulin resistance
Due to genetics, impaired insulin secretion, islet amyloid and environment (obesity)

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4
Q

Type 1 diabetes

A

Genetics + immune system (juvenile)
Progressive and complete

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5
Q

What defines DM in dogs?

A

Hyperglycemia
Glucosuria (renal threshold of glucose)
180-220 mg/dL in dogs

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6
Q

Insulin dependent DM (IDDM)

A

All dogs
↓ insulin, no insulin release after glucose admin, need exogenous insulin
Reduction in size and # of B cells

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7
Q

Non-insulin dependent DM (NIDDM)

A

Obesity-induced carb intolerance
Uncommon in dogs (hyperadrenocorticism)

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8
Q

Signalment for DM

A

4-14y (peak @ 7-10y)
Female > male

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9
Q

Juvenile DM

A

Rare and concurrently exocrine pancreatic insufficiency
2-6m of age
shepherds, keeshounds

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10
Q

CS of DM

A

PU/PD/PP
WL with good appetite
Cataract, KCS
Thinning/ unkempt haircoat, hepatomegaly, m weakness and lethargy

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11
Q

Chemistry of DM

A

Hyperglycemia, -cholesterolemia, -trygliceridemia
Lipemia, ↑ ALT and ALP

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12
Q

Urinalysis of DM

A

Glycosuria
Variable ketonuria
Proteinuria and bacteriuria (UTI)
USG <1.025

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13
Q

Diagnostic testing of DM

A

Frutosamine (average glucose over 2w)
Glycosylated hemoglobin (A1C)

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14
Q

DDX for hyperglycemia glucosuria or insulin resistance

A

Hyperadrenocorticism
Hypersomatotropism (acromegaly)
Pancreatitis
EPI
Fanconi syndrome (glucosuria only, normal blood glucose)

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15
Q

Insulin components

A

Amphorus: soluble, short- acting component
Cystalline: less soluble, long acting

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16
Q

Short-acting insulin

A

Regular insulin (Humulin R or Novolin R)
Lispro (humalong) and Aspart (novolong)- human

17
Q

Regular insulin

A

Given IV, IM, SC
Used to tx DKA in vet med
Onset of action 10-30 min
Duration of action 3-10hrs, depending on route

18
Q

Intermediate- acting insulin

A

NPH (Humulin N or Novolin N)
Porcine origin Lente (vetsulin)
PZI insulin

19
Q

NPH

A

Contains protamine and zinc to delay absorption of insulin
Recombinant human DNA tech (preventing antiinsulin abs)

20
Q

Porcine origin Lente (vetsulin)

A

K9 and porcine insulin have identical aa sequence (eliminates antiisulin abs)
35% amorphous and 65% crystalline

21
Q

PZI insulin

A

ProZinc= protamine zinc recombinant human insulin
More consistently absorbed and long duration than NPH cats

22
Q

Glargine (long lasting)

A

Produced by recombinant DNA tech using E. coli
Results in delayed, prolonged, constant absorption of insulin

23
Q

Insulin Detemir (levemir)

A

Long-acting, recombinant insulin analogue
Slow absorption and long effect due to fatty acid modification → binds reversibly to albumin

24
Q

When would you use insulin detemir

A

Bigger dogs who aren’t regulated using other insulin types

25
Q

Basal insulins

A

Long duration of action
Insulin gargine (Toujeo)
Insulin degludec (tresiba)

26
Q

Goals of therapy

A

Don’t make your patient hypoglycemic
Elimination of CS

27
Q

Dietary Therapy

A

Reduce weight in overweight or obese animals
Complex CHOs, moderate to high fiber (controls hyperglycemia)

28
Q

What causes poor glycemic control in stable diabetics (physiologically)

A

UTI (most common cause)
Hyperadrenocorticism
Pancreatitis
Neoplasia
bacterial pyoderma, otitis

29
Q

What causes poor glycemic control in stable diabetics (owners)

A

Old insulin
Inappropriate handling or administration
Insulin ab development (rare)

30
Q

Complications of DM

A

Poor glycemic control in stable diabetics
KCS
Diabetes induced cataracts (>60%): uveitis, synechia, glaucoma

!Small Animal Medicine (37 decks)

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